Common use of Specific Training Clause in Contracts

Specific Training. Within 90 days of the Effective Date of this CIA, Mariner shall initiate specific training of certain designated Covered Persons, as set forth in this Section. Each Covered Person who is involved in the delivery of patient or resident care (including individuals who are responsible for quality assurance, setting policies or procedures, or making staffing decisions), the preparation or submission of claims for reimbursement or cost reports, or the assignment of procedure codes or other diagnostic assessments that might affect reimbursement, for any Federal health care programs (hereinafter, "Relevant Covered Persons") shall receive at least 2 hours of specific training pertinent to his or her responsibilities (as described below) in addition to the general training required above. This training shall be conducted at least annually thereafter, shall include a discussion of the policies and procedures set forth in Section III.B.2, including, but not limited to: a. the submission of accurate information (e.g., MDS, claims, bills, and cost reports) for services rendered to Medicare or Medicaid beneficiaries, including, but not limited to, the requirements for an accurate clinical assessment, if relevant to the person's duties; b. policies, procedures and other requirements applicable to the documentation of medical records, if relevant to the person's duties; c. the personal obligation of each individual involved in the patient or resident care, documentation, or reimbursement processes to ensure that such submissions are accurate; d. applicable Federal health care program requirements, if relevant to the person's duties; e. the legal sanctions for improper submissions to Federal health care programs; f. examples of relevant reimbursement practices related to Federal health care programs found to have been improper, if relevant to the person's duties; and g. for persons who provide patient or resident care: the coordinated interdisciplinary approach to providing care to residents or patients, including, but not limited to, resident assessment and the requirements of 42 C.F.R. ss. 483. Affected new Relevant Covered Persons shall have begun to receive this training within 30 days of the beginning of their employment or contract, and shall have completed this specific training with 90 days of the beginning of their employment or contract. New Relevant Covered Persons involved in the delivery of patient or resident care or in the preparation or submission of information (including, but not limited to, claims, bills, MDS, or cost reports) to any Federal health care program shall be adequately supervised by trained employees until they have completed the specific training relevant to their duties. Each Relevant Covered Person shall receive the appropriate Specific Training on an annual basis. In addition, each facility shall conduct periodic training on an "as needed" basis (but at least semi-annually) on those quality of care issues identified by the Quality Assurance Committees. In determining what training should be performed, the Quality Assurance Committees will review the complaints received, satisfaction surveys, staff turnover data, any state or Federal surveys, including those performed by the Joint Commission on Accreditation of Healthcare Organizations ("JCAHO"), any internal surveys, and either the CHSRA quality indicators (for long term care facilities) or other relevant indicators (for other types of facilities). Such training will be for the length of time necessary to teach the subject matter. Such training will be provided to all Covered Persons at the facility who are responsible for patient or resident care, or whose job function allows them to contribute to the correction of the alleged deficiency. Mariner shall implement mechanisms to evaluate the individual's competence with respect to the training received.

Specific Training. Within 90 ninety (90) days of the Effective Date of this CIA, Mariner Vencor shall initiate specific training of certain designated Covered Persons, as set forth in this Section. Each Covered Person who is involved in the delivery of patient or resident care (including individuals who are responsible for quality assurance, setting policies or procedures, or making staffing decisions), the preparation or submission of claims for reimbursement or cost reports, or the assignment of procedure codes or other diagnostic assessments that might affect reimbursement, for any Federal health care programs (hereinafter, "Relevant Covered Persons") shall receive at least 2 two (2) hours of specific training pertinent to his or her responsibilities (as described below) in addition to the general training required above. This training training, which shall be completed within two hundred (200) days of the Effective Date of this CIA and conducted at least annually thereafter, shall include a discussion of the policies and procedures set forth in Section III.B.2, including, but not limited to: a. the submission of accurate information (e.g., MDS, claims, ---- bills, and cost reports) for services rendered to Medicare or beneficiaries and/or Medicaid beneficiariesrecipients, including, but not limited to, the requirements for an accurate clinical assessment, if relevant to the person's duties; b. policies, procedures procedures, and other requirements applicable to the documentation of medical records, if relevant to the person's duties; c. the personal obligation of each individual involved in the patient or resident care, documentation, or reimbursement processes to ensure that such submissions are accurate; d. applicable Federal health care program requirements, including requirements relating to quality of care, if relevant to the person's duties; e. the legal sanctions for improper submissions to Federal health care programs; f. examples of relevant reimbursement practices related to Federal health care programs found to have been improper, if relevant to the person's duties; and g. for persons who provide patient or resident care: the coordinated interdisciplinary approach to providing care to residents or patientsresidents, including, but not limited to, resident assessment and the requirements of 42 C.F.R. ss. (S) 483. Affected new Relevant Covered Persons shall have begun to receive this training within 30 thirty (30) days of the beginning of their employment or contract, and shall have completed this specific training with 90 ninety (90) days of the beginning of their employment or contract. New Relevant Covered Persons involved in the delivery of patient or resident care or in the preparation or submission of information (including, but not limited to, claims, bills, MDS, or cost reports) to any Federal health care program shall be adequately supervised by trained employees until they have completed the specific training relevant to their duties. Each Relevant year, every Covered Person shall receive the appropriate Specific Training on an annual basis. In addition, each facility shall conduct at least two hours of periodic training on an "as needed" basis (but at least semi-annually) on those quality of care issues identified by the Quality Assurance Committees. In determining what training should be performed, the Quality Assurance Committees will review the complaints received, satisfaction surveys, staff turnover data, any state or Federal surveys, including those performed by the Joint Commission on Accreditation of Healthcare Organizations ("JCAHO"), any internal surveys, and either the CHSRA quality indicators (for long term care facilities) or other relevant indicators (for other types of facilities)hospital key indicator variables. Such training will be for the length of time necessary to teach the subject matter. Such training will be provided to all Covered Persons at the facility who are responsible for patient or resident care, or whose job function allows them to contribute to the correction of the alleged deficiency. Mariner Vencor shall implement mechanisms to evaluate that training participants comprehended and implemented (where appropriate) the individual's competence with respect to content of the training receivedtraining.

Specific Training. Within 90 days of after the Effective Date Date, WellCare shall require that Relevant Covered Persons receive at least three hours of this CIASpecific Training in addition to the General Training required above. This Specific Training shall include a discussion of: a. all applicable Federal health care program requirements related to Reimbursement Related Functions; b. all WellCare policies, Mariner shall initiate specific training of certain designated Covered Persons, as set forth in this Section. Each Covered Person who is involved in the delivery of patient or resident care (including individuals who are responsible for quality assurance, setting policies or procedures, or making staffing decisions)and other requirements related to Reimbursement Related Functions; c. the personal obligation of each individual in Reimbursement Related Functions to comply with all applicable Federal health care program requirements and all other applicable legal requirements; d. the accurate and complete accounting and reporting of all revenues, the preparation or submission of claims for reimbursement or cost reports, or the assignment of procedure codes or other diagnostic assessments that might affect reimbursement, for expenditures and costs incurred in providing any service to any Federal health care programs (hereinafterprogram beneficiary or submitted to any Federal health care program; e. the accurate and complete reporting of all Federal health care program information; f. the accurate and complete preparation, "Relevant Covered Persons") shall receive at least 2 hours of specific training pertinent to his or her responsibilities (as described below) in addition to the general training required above. This training shall be conducted at least annually thereaftercertification, shall include a discussion of the policies and procedures set forth in Section III.B.2, including, but not limited to: a. the submission of accurate information (e.g., MDS, claims, bills, and cost reports) for services rendered bids to Medicare or Medicaid beneficiaries, including, but not limited to, the requirements for an accurate clinical assessment, if relevant to the person's dutiesFederal health care programs; b. g. policies, procedures procedures, and other requirements applicable to the documentation of medical records, if relevant to the person's duties; c. h. Federal health care program requirements regarding the personal obligation accurate coding and submission of each individual involved in the patient or resident care, documentation, or reimbursement processes to ensure that such submissions are accurateclaims; d. i. all applicable reimbursement statutes, regulations, and program requirements and directives; j. the legal sanctions for violations of the Federal health care program requirements; and Corporate Integrity Agreement WellCare Health Plans, if relevant to the person's duties;Inc. e. the legal sanctions for k. examples of proper and improper submissions accounting and reporting of expenditures and other information to Federal health care programs; f. examples of relevant reimbursement practices related , and proper and improper claims submission practices. To the extent that WellCare provided Specific Training to Federal health care programs found to have been improper, if relevant Relevant Covered Persons during the 180 days immediately prior to the person's duties; and g. Effective Date that satisfied the requirement set forth in Section III.C.2 above, WellCare is not required to repeat initial Specific Training for persons who provide patient or resident care: those individuals for the coordinated interdisciplinary approach to providing care to residents or patients, including, but not limited to, resident assessment and the requirements of 42 C.F.R. ssfirst Reporting Period. 483. Affected new New Relevant Covered Persons shall have begun to receive this training within 30 days of after the beginning of their employment or contractbecoming Relevant Covered Persons, and shall have completed this specific training with or within 90 days of after the beginning of their employment or contractEffective Date, whichever is later. New A new Relevant Covered Persons involved in the delivery of patient or resident care or in the preparation or submission of information (including, but Person who has not limited to, claims, bills, MDS, or cost reports) to any Federal health care program shall be adequately supervised by trained employees until they have completed the specific Specific Training shall not perform Reimbursement Related Functions until such time as he or she completes his or her Specific Training consistent with categories of work that trigger training relevant to their dutiesin this Section. Each After receiving the initial Specific Training described in this Section, each Relevant Covered Person shall receive the appropriate at least two hours of Specific Training on an annual basis. In addition, in each facility shall conduct periodic training on an "as needed" basis (but at least semi-annually) on those quality of care issues identified by the Quality Assurance Committees. In determining what training should be performed, the Quality Assurance Committees will review the complaints received, satisfaction surveys, staff turnover data, any state or Federal surveys, including those performed by the Joint Commission on Accreditation of Healthcare Organizations ("JCAHO"), any internal surveys, and either the CHSRA quality indicators (for long term care facilities) or other relevant indicators (for other types of facilities). Such training will be for the length of time necessary to teach the subject matter. Such training will be provided to all Covered Persons at the facility who are responsible for patient or resident care, or whose job function allows them to contribute to the correction of the alleged deficiency. Mariner shall implement mechanisms to evaluate the individual's competence with respect to the training receivedsubsequent Reporting Period.

Specific Training. Within 90 120 days of the Effective Date effective date of this CIACCA, Mariner shall initiate specific training of certain designated Covered Persons, as set forth in this Section. Each each Covered Person who is a physician or is involved in the delivery of patient or resident care (including individuals who are responsible for quality assurance, setting policies or procedures, or making staffing decisions), the preparation or submission of claims for reimbursement or cost reports, or the assignment of procedure codes or other diagnostic assessments that might affect reimbursement, for any Federal health care programs (hereinafter, "Relevant Covered Persons") shall receive at least 2 hours of specific training pertinent to his or her responsibilities (as described below) in addition to the general training required above. This training shall be conducted at least annually thereafter, shall include a discussion of the policies and procedures set forth in Section III.B.2, including, but not limited to, coding and billing) from any Federal health care program shall receive at least four (4) hours of training (the "Specific Training") in addition to the General Training required above. CHS shall ensure that, pursuant to the Corporate Compliance Program, and as appropriate to the Covered Person's individual responsibilities, the Specific Training includes a discussion of: a. the submission of accurate information (e.g., MDS, claims, bills, and cost reports) bills for services rendered to Medicare or Medicaid beneficiaries, including, but not limited to, the requirements for an accurate clinical assessment, if relevant to the person's dutiesFederal health care program patients; b. policies, procedures and other requirements applicable to the documentation of medical records, if relevant to the person's duties; c. the personal obligation of each individual involved in the patient or resident care, documentation, or reimbursement processes billing process to ensure that such submissions xxxxxxxx are accurate; d. applicable Federal health care reimbursement statutes, regulations, and program requirements, if relevant to the person's dutiesrequirements and directives; e. the legal sanctions for improper submissions to Federal health care programs;xxxxxxxx; and f. examples of relevant reimbursement practices related to Federal health care programs found to have been improper, if relevant to proper and improper billing practices. Persons providing the person's duties; and g. for persons who provide patient or resident care: Specific Training must be knowledgeable about the coordinated interdisciplinary approach to providing care to residents or patients, including, but not limited to, resident assessment and the requirements of 42 C.F.R. ss. 483subject area. Affected new Relevant Covered Persons shall have begun to receive this training the Specific Training within 30 days of the beginning of their employment becoming a Covered Person or contract, and shall have completed this specific training with 90 within 120 days of the beginning effective date of their employment this CCA, whichever is later. If a new Covered Person who is a physician or contract. New Relevant Covered Persons is involved in the delivery of patient or resident care or in the preparation or submission of information claims for reimbursement (including, but not limited to, coding and billing) from any Federal health care program has any responsibility for the delivery of patient care, the preparation or submission of claims, billsand/or the assignment of procedure codes prior to completing this Specific Training, MDSa Covered Person who has completed the Specific Training shall review all of the untrained person's work regarding the delivery of patient care, the preparation or submission of claims, and the assignment of procedure codes. Covered Persons who have received the above-required Specific Training, or cost reportsits equivalent, within 12 months prior to the effective date of this CCA are exempted from the above four (4) hour Specific Training requirement for the first year of this CCA only. CHS shall maintain records sufficient to support a listing of those Covered Persons for whom CHS is claiming such an exemption as well as the date(s) and topics of the training received by those Covered Persons. Every Covered Person who is a physician or is involved in the preparation or submission of claims for reimbursement (including, but not limited to, coding and billing) from any Federal health care program shall be adequately supervised by trained employees until they have completed the specific training relevant to their duties. Each Relevant Covered Person shall receive the appropriate at least four (4) hours of such Specific Training on an annual basis. In addition, each facility shall conduct periodic All training on an "as needed" basis (but at least semi-annually) on those quality of care issues identified by the Quality Assurance Committees. In determining what training should be performed, the Quality Assurance Committees will review the complaints received, satisfaction surveys, staff turnover data, any state or Federal surveys, including those performed by the Joint Commission on Accreditation of Healthcare Organizations ("JCAHO"), any internal surveys, and either the CHSRA quality indicators (for long term care facilities) or other relevant indicators (for other types of facilities). Such training will be materials used for the length of time necessary Specific Training shall be made available to teach the subject matter. Such training will be provided to all Covered Persons at the facility who are responsible for patient or resident care, or whose job function allows them to contribute to the correction of the alleged deficiency. Mariner shall implement mechanisms to evaluate the individual's competence with respect to the training receivedOIG upon request.